Let Us Choose Wisely: Families and Doctors Partnering to Reduce Overuse of Tests & Procedures at Children's Hospital of Pittsburgh of UPMC

Grant Application

Srinivasan Suresh, MD, MBA, Children’s Hospital of Pittsburgh of UPMC

 

Proposed Innovation

Experts believe as much as 30 percent of health care delivered in the United States is duplicative, or unnecessary, and sometimes harmful. Choosing Wisely® is an initiative aimed at reducing unnecessary tests and procedures by encouraging dialogue between doctors and patients so they can make smart and effective care choices. As part of Choosing Wisely, the American Academy of Pediatrics (AAP) has formulated a list of 10 things physicians, patients, and families should question — along with specific, evidence-based recommendations they should discuss — concerning appropriate care for their individual situation.

The goal of this project is to educate providers at Children’s Hospital of Pittsburgh on the AAP’s recommendations and encourage collaboration through conversations between pediatricians, patients, and families about wise treatment decisions.

 

Improvements in Action

The AAP’s list of “10 things that physicians and patients should question” will be distributed to all clinical providers as the primary education tool.

Whenever providers encounter pediatric patients with some of these conditions or diagnoses, a prompt in the electronic health record will remind them to take a closer look at each test or treatment. Parents and patients also will be encouraged to ask these five questions at point-of-care:

  1. Do I really need this test or procedure?
  2. What are the downsides?
  3. Are there simpler, safer options?
  4. What happens if I do nothing?
  5. How much does it cost?

 

Results – In Progress

Through this project, tools will be produced to help clinicians understand and share decision making on the basis of best evidence. It also will place patients and their families at the center of the health care decision-making process by encouraging them to ask questions on recommended treatments. The project will be analyzed to measure improvements in care outcomes and patient satisfaction, cost, and efficiency.